Background/Objectives: In this prospective clinical follow-up study, we aimed to evaluate the long-term periodontal responses over a five-year follow-up period associated with Class II direct posterior restorations placed using two different restorative approaches. Materials and Methods: Thirty-one Class II posterior restorations in 25 patients were included. Eighteen were performed using a bulk-fill approach with Admira Fusion X-tra® (VOCO, Cuxhaven, Germany), whereas thirteen used the proximal wall approach with Admira Fusion® (VOCO, Cuxhaven, Germany). Periodontal parameters, including plaque control record, gingival bleeding index, probing depth, and clinical attachment loss, were recorded at baseline and five years using standardized periodontal examination procedures. Data were expressed as mean ± standard deviation and analyzed using repeated-measures ANOVA. Given the limited sample size, the statistical analyses were considered exploratory. Results: The plaque control record decreased from baseline to the five-year follow-up, with a significant overall effect of time (F = 4.789, p = 0.037), while the time × restorative approach interaction was not significant (p = 0.694). The gingival bleeding index showed a slight numerical increase over the five-year period (25.52 ± 27.20% at baseline versus 27.00 ± 26.11% at five years); however, neither the effect of time (F = 0.139, p = 0.712) nor the time × restorative approach interaction (F = 0.505, p = 0.483) was statistically significant. Probing depth and clinical attachment loss remained relatively stable throughout the observation period, with no statistically significant time or interaction effects. Overall, no statistically significant time × restorative approach interactions were observed, indicating that longitudinal changes in the evaluated periodontal parameters did not differ significantly between the restorative approaches. Conclusions: Within the limitations of this exploratory clinical study, both ormocer-based restorative protocols were not associated with detectable deterioration in the evaluated periodontal parameters over the five years of follow-up.

Background: Mechanical subgingival instrumentation remains the gold standard in periodontitis treatment; however, it may leave residual debris and induce surface alterations. Adjunctive strategies such as air polishing and ethylenediaminetetraacetic acid (EDTA) might optimize root surface conditions. Objective: To evaluate, by scanning electron microscopy (SEM), the effects of scaling and root planing (SRP) combined with EDTA, with or without adjunctive erythritol- or glycine-based air polishing, on root surface alterations and smear layer formation. Materials and Methods: Ten extracted human teeth affected by periodontitis (yielding twenty samples) were included. Two teeth served as descriptive controls. The remaining teeth were allocated to four treatment groups. The first three groups included samples obtained from the middle portion of the roots: S (SRP + EDTA), Se (SRP + erythritol air polishing + EDTA), and Sg (SRP + glycine air polishing + EDTA). The fourth group, Js, consisted of samples from the cementoenamel junction (CEJ) treated with SRP + EDTA. SEM images were appreciated qualitatively and assessed using ordinal scores (0–3) for marks, cracks (×100), and smear layer (×1000). Non-parametric statistics were applied. Results: A significant difference in mark scores was found among S, Se, and Sg samples (H = 13.411, p = 0.001), with Se samples showing lower mark scores than S (p = 0.001). Crack scores also differed among groups (H = 12.038, p = 0.002), with higher values observed in Se compared to S (p = 0.001). Smear layer scores did not differ among groups (H = 0.102, p = 0.950). Compared with S samples, Js differed only in marks (p = 0.009), with no significant differences in cracks or smear layer. Conclusions: Within the limitations of this in vitro study, root surface alterations and smear layer formation showed variable responses across treatment protocols, with comparable smear layer scores. Similar effects were observed for CEJ and mid-root samples; however, these findings should be interpreted with caution. Further studies are needed to clarify the potential clinical relevance of these observations.

Background/Objectives: To evaluate the clinical effects of alveolar ridge preservation using a hyaluronic acid-based product combined with a resorbable collagen cone compared with spontaneous healing. Methods: In this prospective pilot comparative clinical study, extraction sockets were treated either with hyaluronic acid and a collagen cone (test group) or left to heal spontaneously (control group). Mesial and distal ridge height changes (ΔHm, ΔHd), ridge width reduction (ΔW), buccal mucosal thickness changes (ΔTmb), and occlusal mucosal thickness at 3 months (TmoT3) were assessed. Early wound healing was appreciated at 14 days follow-up, and postoperative complications after 7 and 14 days. Results: Complete 3-month follow-up data were available for 18 test and 14 control patients. Mesial bone loss was significantly lower in the test group than in controls [test ΔHm = 1.0 (1.0–1.0) vs. control ΔHm = 2.0 (1.0–2.0); p < 0.001]. Horizontal ridge width reduction was significantly lower in the test group [ΔW = 1.0 (1.0–1.0) vs. 2.0 (1.0–2.0); p = 0.021]. Buccal mucosal thickness was better maintained in the test group [ΔTmb = 0.0 (0.0–0.5) vs. 1.0 (0.5–1.0); p < 0.001], while TmoT3 was greater in the test group, in an exploratory analysis (p = 0.049). A statistically significant difference in early wound-healing scores favoring the test group was observed [4.0 (4.0–5.0) vs. 4.0 (3.0–4.0); p = 0.032]. No statistically detectable difference in postoperative complications was observed between groups. Conclusions: Alveolar ridge preservation was associated with reduced mesial vertical and horizontal dimensional changes and more favorable soft tissue outcomes compared with spontaneous healing. These preliminary findings should be considered hypothesis-generating.

Background/Objectives: Periodontitis, a prevalent chronic inflammatory disease affecting tooth-supporting structures, has been increasingly linked to systemic conditions such as diabetes mellitus (DM) and cardiovascular diseases (CVDs). This study aimed to evaluate the periodontal status and levels of dipeptidyl peptidase-4 (DPP-4) and galectin-3 (Gal-3) in gingival crevicular fluid (GCF) of patients with periodontitis, heart failure (HF), and diabetes, exploring their potential as biomarkers for disease association. Methods: A cross-sectional study was conducted on 88 patients categorized into four groups: periodontally and systemically healthy (control, C); periodontitis (P); periodontitis and HF (P+HF); and periodontitis, HF, and diabetes (P+HF+D). Periodontal status was assessed using probing pocket depth (PPD) and Gingival Index (GI). GCF samples were collected and analyzed for DPP-4 and Gal-3 levels using ELISA. Statistical analyses were performed to assess differences between groups and potential correlations. Results: Results indicated significantly higher levels of DPP-4 in all test groups compared to controls (p < 0.0001), with the highest levels in the P+HF+D group. Similarly, Gal-3 levels were elevated in periodontitis patients, particularly in those with HF (p < 0.0001), and there was no significant difference between P+HF and P+HF+D groups. No significant differences were observed between smokers and non-smokers regarding these markers. Positive correlations were found between the periodontal parameters and the immunological markers in all test groups. Conclusions: The findings suggest that DPP-4 and Gal-3 may serve as potential biomarkers for periodontitis in association with heart failure and diabetes, with DPP-4 being more upregulated in the association with diabetes and Gal-3 with heart failure.

Periodontitis is a biofilm-induced multifactorial disease characterized by non-reversible damage of the periodontal tissues. Dysbiosis of the subgingival microbiota plays a crucial role in periodontitis. In this regard, conventional periodontal treatment consists of subgingival mechanical instrumentation, but adjunctive methods, such as air-polishing powders, have also sparked considerable interest due to their ability to efficiently disrupt biofilm with minimal tissue damage. The aim of this narrative review is to provide an overview and critical discussion of the recent literature on the properties and interactions of air-polishing powders with oral bacteria and soft tissues. Fifteen studies were included. Eight recent clinical studies demonstrate that air-polishing powders (e.g., glycine, erythritol) can significantly reduce periodontal pathogens, thereby supporting their role in effective biofilm control; In vitro evidence from four included studies indicates cell-type-specific responses to different powders, with trehalose demonstrating superior biocompatibility compared with glycine and erythritol/chlorhexidine formulations. This variability highlights the importance of choosing the right powder to improve clinical outcomes and reduce tissue side effects. By integrating microbiological, cellular and histological findings, the objective of this review is to clarify the antibacterial efficacy and biocompatibility of air-polishing powders. Overall, air-polishing powders have been shown to be safe and effective as an adjunctive treatment, in both active periodontal and supportive periodontal therapy.

Objectives. Periodontal health can influence systemic health and reproductive outcomes. In women undergoing pre-fertilization treatment, understanding the state of oral health, specifically the bleeding on probing (BOP) index, and factors such as oral hygiene practices, is essential. The objective of the present study is to evaluate the association between oral hygiene practices and BOP index in a group of women preparing for fertilization treatments. Methods. The present study includes 28 women undergoing pre-fertilization treatment in whom gingival inflammation was recorded through a periodontal examination, and data regarding personal oral hygiene habits were collected through a questionnaire. Results. The present study findings have shown that most of the included patients change their toothbrush every 3 months, but only 10, respectively 8 of the included patients use mouthwashes and interdental aids in addition to the toothbrush. A significant difference was reported between the frequency with which the included patients visit their dentist for check-ups (< 1 time / year) and the BOP index value. Conclusions. The BOP index value tends to be higher in patients who do not use interdental cleaning aids and also in patients who do not regularly visit the dentist for check-ups. Including periodontal assessments into fertility care may improve outcomes, as poor oral health is linked to systemic inflammation that could impact reproduction.

Background/Objectives: Tooth extraction induces significant alveolar ridge dimensional changes and soft tissue modifications, often leading to challenges in implant placement or conventional prosthetic rehabilitation. Alveolar Ridge Preservation (ARP) strategies aim to mitigate post-extraction resorption of the alveolar ridge, enhancing both the quality and quantity of bone and soft tissue during healing. Hyaluronic acid (HYA) has emerged as a promising biological agent for ARP due to its osteoinductive, antimicrobial, and anti-inflammatory properties. However, the effects of HYA in ARP remain inconsistently reported. This study aims to assess current clinical and preclinical evidence regarding the biological effects of HYA and its application in ARP. Additionally, it evaluates HYA’s impact—alone or in combination with other products—on hard and soft tissue dimensional changes, early wound healing, and implant success rates. Methods: A comprehensive electronic literature search was conducted, and studies meeting the inclusion criteria were critically evaluated. Relevant data were extracted from the final selection of articles. Results: Thirteen publications were evaluated. Some studies reported a significantly improved newly formed bone following ARP with intra-socket HYA application as a single approach (p = 0.004). Combining HYA with a bone graft and a free palatal graft resulted in significantly greater amounts of newly formed and mature bone, reduced clinical bone width changes, lower radiographic crestal bone loss (p < 0.01), and diminished radiological volumetric and linear bone resorption (p = 0.018). Short-term follow-up data indicated improved soft tissue healing associated with HYA-based ARP. While HYA appears to have a protective effect on ridge dimensional changes in ARP, other studies reported no significant differences in radiographic bone dimensional changes or soft tissue improvement. Conclusions: The addition of HYA to bone grafts may enhance some ARP outcomes. However, the variability in outcomes and methodologies across the evaluated studies precludes drawing definitive clinical conclusions. Further robust research is needed to clarify HYA’s role in ARP. With respect to clinical significance enhancing the understanding of ARP management strategies and their effects on post-extraction sockets empowers clinicians to make more informed decisions. The knowledge of HYA effects facilitates the selection of personalized ARP approaches tailored to optimize outcomes for subsequent interventions.

Background: Maintaining daily optimal dental hygiene, especially in medically vulnerable patients with periodontitis, remains challenging in dental practice. Mobile apps and other digital tools might offer useful support alongside traditional advice. Objectives: This study aimed to develop a mobile health app, PerioSupportPro, that helps patients improve their daily plaque control habits. It also reports on the pilot testing of the app’s usability and users’ perception in a small patient group. Methods: The app was created by a mixed team including periodontists, psychologists, developers, and data protection specialists. The first version included reminders, gamified elements, video tutorials, and motivational messages. After internal testing, a group of 18 patients tested the app and completed a feedback questionnaire that assessed usability (Q3–Q5), educational impact (Q6–Q8), motivation (Q9–Q11), and overall satisfaction (Q12–Q14). Cronbach’s alpha was used to check internal consistency, and non-parametric tests were applied for basic statistical comparisons. Results: The motivation section of the questionnaire showed acceptable consistency (α = 0.784), while usability and educational impact had lower values (α = 0.418 and 0.438). No clear differences were found between age groups. Satisfaction was positively associated with reminders and motivational items. Most appreciated features included reminders, the simple interface, and short videos. Based on the input provided by the questionnaire, a few improvements were made, and a second version of the app was prepared. Conclusions: Early user responses show that PerioSupportPro may help motivate and guide patients in their oral hygiene routine. While still in an early phase, the app seems well-received and ready for future clinical validation with more users.

(1) Background: This study aimed to assess the periodontitis burden in systemic sclerosis patients and the possible association between them, and the degree to which some potential risk factors and two potential diagnostic biomarkers may account for this association. (2) Methods: This cross-sectional study included a test group (systemic sclerosis patients) and a control group (non-systemic sclerosis patients). Both groups benefited from medical, periodontal examination and saliva sampling to determine the salivary flow rate and two inflammatory biomarkers (calprotectin, psoriasin). A systemic sclerosis severity scale was established. (3) Results: In the studied groups, comparable periodontitis rates of 88.68% and 85.85%, respectively, were identified. There were no significant differences in the severity of periodontitis among different systemic sclerosis severity, or in the positivity for anti-centromere and anti-SCL70 antibodies. Musculoskeletal lesions were significantly more common in stage III/IV periodontitis (n = 33, 86.84%) than in those in stage I/II (n = 1, 100%, and n = 3, 37.5%, respectively) (p = 0.007). Comparable levels of the inflammatory mediators were displayed by the two groups. There were no significant differences in calprotectin and psoriasin levels between diffuse and limited forms of systemic sclerosis. (4) Conclusions: Within the limitations of the current study, no associations between systemic sclerosis and periodontitis, or between their risk factors, could be proven.

(1) Background: This cross-sectional investigation appreciated the role of serum C-reactive protein (CRP), several hematologic-cell markers, and salivary inflammation-related molecules [calprotectin (S100A8/A9), interleukin-1β (IL-1β), kallikrein] to predict periodontitis in patients with atherosclerotic cardiovascular disease (ACVD), arrhythmia, or both. Also, we appreciated the relationship between the inflammatory burden and periodontal destruction with the type of cardiac pathology. (2) Methods: Demographic, behavioral characteristics, periodontal indicators, blood parameters, and saliva samples were collected. (3) Results: All 148 patients exhibited stage II or III/IV periodontitis. Stage III/IV cases exhibited significantly increased S100A8/A9 levels (p = 0.004). A positive correlation between S100A8/A9 and IL-1β [0.35 (<0.001)], kallikrein [0.55 (<0.001)], and CRP [0.28 (<0.001)] was observed. Patients with complex cardiac involvement had a significantly higher number of sites with attachment loss ≥ 5 mm [19 (3–30)] compared to individuals with only arrhythmia [9 (3.25–18)] or ACVD [5 (1–12)] [0.048♦ {0.162/0.496/0.14}]. (4) Conclusions: Severe, extensive attachment loss may be indicative of patients with complex cardiac conditions, which underscores the essential role of periodontal status in relation to systemic diseases. The correlations between the rising trends of the inflammatory parameters suggest a potential interconnection between oral and systemic inflammation.

Introduction: Periodontitis, an infectious inflammatory condition, is a key contributor to sustained systemic inflammation, intricately linked to atherosclerotic cardiovascular disease (CVD), the leading cause of death in developed nations. Treating periodontitis with subgingival mechanical instrumentation with or without adjunctive antimicrobials reduces the microbial burden and local inflammation, while also potentially bringing systemic benefits for patients with both periodontitis and CVD. This review examines systemic effects of subgingival instrumentation with or without antimicrobial products in individuals with periodontitis and CVD, and explores intricate pathogenetic interactions between periodontitis and CVD. Material and Methods: English-language databases (PubMed MEDLINE and Cochrane Library) were searched for studies assessing the effects of nonsurgical periodontal therapies in periodontitis patients with or without CVD. Results: While the ability of periodontal therapy to reduce mortality- and morbidity-related outcomes in CVD patients with periodontitis remains uncertain, some studies indicate a decrease in inflammatory markers and blood cell counts. Subgingival mechanical instrumentation delivered over multiple short sessions carries lower risks of adverse effects, particularly systemic inflammation, compared to the full-mouth delivery, making it a preferable option for CVD patients. Conclusions: Subgingival mechanical instrumentation, ideally conducted in a quadrant-based therapeutic approach, to decontaminate periodontal pockets has the potential to reduce both local and systemic inflammation with minimal adverse effects in patients suffering from periodontitis and concurrent CVD.

1) Background: Periodontitis is a chronic infectious, inflammatory disease associated with sig-nificant local disastrous effects due to alveolar bone destruction and systemic morbidities. Some associations between periodontitis and coronary and cerebrovascular diseases have been high-lighted in the literature. The present study investigated a group of patients with atherosclerotic cardiovascular diseases and periodontitis and aimed to as-sess the comprehensive effects of nonsurgical periodontitis treatment. (2) Methods: The present study included 11 patients with atherosclerotic cardiovascular disease and perio-dontitis, that were diagnosed after a complete and a complex periodontal evaluation. These patients received periodontal treatment and peri-odontal reevaluation after 2 months from initial therapy. (3) Results: A significant improvement of the oral hygiene and gingival bleeding scores was recorded at two months follow-up. For moderate pockets of 5 mm, there was a significant reduction of their median values at two months follow-up moment (p=0.021). (4) Conclusion: The nonsurgical periodontal treatment significantly improves the clinical-related parameters of the periodontal tissues, as revealed by gingival bleeding and pocket closure.

Both diabetes mellitus (a series of metabolic illnesses characterised by hyperglycemia) and periodontitis (an inflammatory disorder affecting the supporting tissues of teeth and caused by microorganisms) are widespread and persistent health problems. diabetes mellitus (both type 1 and type 2) has been shown to increase the likelihood of developing periodontitis in a number of studies. mechanistic studies show that diabetes mellitus causes a hyperinflammatory response to the periodontal microbiota, which therefore speeds up the loss of the gums and teeth. Since periodontitis has been shown to negatively impact glycemic control in people with diabetes mellitus and to contribute to the development of diabetic complications, the relationship between the two illnesses is two-way. Meta-analyses have also found that periodontal care for those with diabetes mellitus can lead to a little enhancement of glycemic control. Increased levels of systemic proinflammatory mediators may explain the impact of periodontal infections on diabetes mellitus, which in turn worsens insulin resistance. Increased patient awareness of the connection between diabetes mellitus and oral health and collaboration between medical and dental professionals for the management of affected individuals become increasingly important as our understanding of the relationship between the two conditions grows.

OBJECTIVES:The objectives of this research were to compare, retrospectively, the clinical and radiographic modifications of periodontal parameters and peri-implant conditions and to analyze the relationship between the changes in periodontal parameters and peri-implant conditions over a mean follow-up period of 7.6 years in a treated population with progressive/uncontrolled periodontitis and at least one unaffected/minimally affected implant.MATERIALS AND METHODS:Nineteen partially edentulous patients having 77 implants inserted, with a mean age of 54.84 ± 7.60 years, were matched for age, gender, compliance, smoking status, general health, and implant characteristics. Periodontal parameters were evaluated in the remaining teeth. Means per teeth and implants were used when making comparisons.RESULTS:Statistically significant differences were observed between baseline and final examination in teeth for tPPD, tCAL and MBL. Furthermore, at 7.6 years, statistically significant differences existed between implants and teeth with regard to iCAL and tCAL (p = 0.03). Multiple regression analyses were performed and revealed a significant association regarding iPPD and CBL with smoking and periodontal diagnosis. In addition, FMBS was significantly associated with CBL. Unaffected/minimally affected implants were found more frequently in the posterior mandible, with longer lengths (>10 mm) and small diameters (<4 mm), including in screwed multi-unit bridges.CONCLUSIONS:The study results appear to reflect minimally affected mean crestal bone-level loss around implants in comparison to the marginal bone-level loss around teeth when exposed to uncontrolled severe periodontal disease over a mean period of observation of 7.6 years, while the unaffected/minimally affected implants seemed to benefit from a combination of clinical factors, including posterior mandibular position, smaller diameters, and screwed multi-unit restorations.

Objectives. The present pilot study was carried out to evaluate the periodontal status, the levels of interleukin-6 and tumor necrosis factor alpha in gingival crevicular fluid on hospitalized patients with colorectal cancer. Materials and Methods. The sample of our study was represented by 74 patients with colorectal cancer. They were assigned to one of the two study groups, based on cancer’s stages, as follows: (i) stage III-IV: 51 patients (A-group); (ii) stage III: 23 patients (B-group). For each participant periodontal parameters were recorded and gingival crevicular fluid samples were collected and immunologically assessed. Results. Statistically significant differences were found between the two groups, regarding probing pocket depth, clinical attachment loss, bleeding on probing, interleukin-6 and tumor necrosis factor alpha. In A-group, statistically significant correlations were found between the inflammatory markers and probing pocket depth and between their levels and bleeding on probing. In B-group, statistically significant correlation was found between the levels of interleukin-6 and bleeding on probing. Conclusions. Our results suggest an association between the severity of periodontitis, the studied immunologic inflammatory markers and colorectal cancer’s severity.

Cervicofacial odontogenic infections can have an aggressive evolution with life-threatening complications. Management in many cases can be a challenge for clinicians, implying an extra focus on individual inflammatory parameters. The aim of this study is to evaluate the evolution of inflammatory markers for the included diagnosed odontogenic cervicofacial phlegmon cases at the moment of hospitalization and after receiving surgical and pharmaceutical treatment. Materials and methods: A total of 39 patients diagnosed with odontogenic cervicofacial phlegmons that were admitted to the Maxillofacial Surgery Department of the Emergency Hospital from Timisoara were included in the study. The main focus was the parameters represented by the systemic immune-inflammatory index (SII) based on neutrophil, platelet, and lymphocytes count; the neutrophil–lymphocyte ratio (NLR); C-reactive protein level (CRP); and white blood cell count (WBC) before and after the treatment as potential prognosis factors. Results: The results of the study after analyzing the included parameters revealed a significant difference between the calculated values of the SII, NLR, CRP, and WBC at admission and at time of discharge, being directly influenced by the treatment. Conclusions: SII, NLR, CRP, and WBC dynamic changes in severe cervicofacial odontogenic infections can be influenced by receiving accurate surgical and pharmacological treatment, with the potential to become future severity prognosis indexes.

Background: Pentraxin 3 (PTX3) is associated with periodontal tissue inflammation, a condition that precedes alveolar bone resorption. It is also elevated in obese tissues and is a useful biomarker of proinflammatory status. Serum amyloid A (SAA) is a proinflammatory and lipolytic adipokine. Adipocytes strongly express SAA, which suggests that it may have a significant role in the production of free fatty acids and local and systemic inflammation. Materials and Methods: We statistically analyzed the gingival crevicular fluid (GCF) values of PTX3 and SAA in patients with periodontal disease, who were diagnosed with obesity, and compared them with the values of inflammatory markers from patients diagnosed with one of the diseases and with healthy patients. Results: The patients with obesity and periodontitis had significantly higher levels of PTX3 and SAA than the patients diagnosed with either obesity or periodontitis. Conclusions: These two markers are involved in the association between the two pathologies, as evidenced by the correlations between these levels and some clinical parameters.

Objectives. The aim of this in vitro study was to observe through scanning electron microscopy (SEM) the surface morphology of root samples treated with different mechanical instrumentation methods and the additional application of a nano-colloidal silver-based antiseptic solution. Material and methods. Root samples were prepared from extracted molars and divided in four groups: group 1 of samples was instrumented with Gracey curette (7/8), group 2 of samples was instrumented with ultrasonic tip 1S, group 3 of samples was instrumented with ultrasonic tips 1S plus H4R/L, group 4 of samples was treated with ultrasonic tips 1S plus H4R/L and application of the silver-based antiseptic solution. All samples were then subjected to SEM examination. Outcomes. Group 1 of samples presented a smoother surface compared to the samples in the other groups. Group 2, 3 and 4 displayed superficial grooves parallel to the direction of action of the ultrasonic tip. In group 3 and 4, root planning with tip H4R/L did not ameliorate the smoothness of the surface. The smear layer was present, regardless the instrumentation method. In group 4, the additional application of the antiseptic solution did not influence the surface morphology or the amount of smear layer. Conclusions. Gracey curettes created a smoother radicular surface compared to ultrasonic tips. Smear layer was obvious on the radicular surfaces, no matter the instrumentation method. The application of the silver-based antiseptic solution had no additional impact on surface morphology.

Objectives: Tissue breakdown was obtained by placing ligatures around dental implants on the same edentulous dog hemimandible. Evaluation of hard tissue loss progression was performed using intravital fluorochrome labeling, as an alternative to standard light microscopy, on thin sections of non-demineralized hybrid bone-implant specimens. Material and Methods: Intravital fluorochrome labeling was administered by intraperitoneal injection of oxytetracycline and alizarin red S. Sections were cut, stained and evaluated by light microscopy and under the epifluorescent microscope. Bone loss architecture was analyzed under three filters: UV, green and red. Results: Epifluorescence microscopy demonstrated continuous bone activity in the surrounding area of the implants during the healing period. LM confirmed the intense cellular activity in the hard tissues around the implants. Conclusion: Within the limits of the present study, epifluorescence can be seen as a complementary approach to the LM “golden standard”, providing both reliable and sufficient information with regard to bone resorption/apposition kinetics.

Periodontitis is one of the most common oral polymicrobial infectious diseases induced by the complex interplay between the altered subgingival microbiota and the host’s dysregulated immune-inflammatory response, leading to the initiation of progressive and irreversible destruction of the periodontal tissues and eventually to tooth loss. The main goal of cause-related periodontal therapy is to eliminate the dysbiotic subgingival biofilm in order to arrest local inflammation and further periodontal tissue breakdown. Because, in some cases, subgingival mechanical instrumentation has limited efficiency in achieving those goals, various adjunctive therapies, mainly systemic and locally delivered antimicrobials, have been proposed to augment its effectiveness. However, most adjunctive antimicrobials carry side effects; therefore, their administration should be precociously considered. HybenX® (HY) is a commercial therapeutical agent with decontamination properties, which has been studied for its effects in treating various oral pathological conditions, including periodontitis. This review covers the current evidence regarding the treatment outcomes and limitations of conventional periodontal therapies and provides information based on the available experimental and clinical studies related to the HY mechanism of action and effects following its use associated with subgingival instrumentation and other types of dental treatments.